Although clinical studies revealed that three itraconazole pulses are sufficient to cure non-complicated onychomycoses of the toe nails, in common practice this dose sometimes does not suffice. Patients with onychomycoses are frequently senior citizens with an impaired blood supply of the lower extremities and slow growth of the nails. Recent clinical studies indicate in these instances that it is useful to add further itraconazole pulses either by protraction of the treatment from 3 to 4 months or to add a so-called additional pulse 6 months after the onset of therapy.

        Key words: onychomycoses - itraconazole - additional pulse